Selective Digestive Decontamination Attenuates Organ Dysfunction in Critically Ill Burn Patients.

Objective: To evaluate whether selective decontamination of the digestive tract (SDD) attenuates organ dysfunction in critically ill burn patients.

Background: The effect of SDD on the development and progression of organ dysfunction, as an important determinant of mortality in burned patients, is still unknown. We asked whether organ dysfunction is mitigated by treatment with SDD.

Long-term use of selective decontamination of the digestive tract does not increase antibiotic resistance: a 5-year prospective cohort study.

Purpose: Despite the evidence, the use of selective decontamination of the digestive tract (SDD) remains controversial, largely because of concerns that it may promote the emergence of antibiotic-resistant strains. The purpose of this study was to evaluate the long-term incidence of carriage of antibiotic-resistant bacteria (ARB), its clinical impact on developing infections and to explore risk factors of acquiring resistance.

Methods: This study was conducted in one 18-bed medical-surgical intensive care unit (ICU).

Limb intracompartmental sepsis in burn patients associated with occult infection.

Background: Intracompartmental sepsis (IS) is a rare complication in burn patients. IS presents in patients with inadequate perfusion of intracompartmental tissues with subsequent ischaemic necrosis and infection. Contributing factors include high-volume resuscitation, delayed escharotomies and previous bacteraemias.

Vancomycin MICs did not creep in Staphylococcus aureus isolates from 2002 to 2006 in a setting with low vancomycin usage.

Objectives: The aim of this study was to evaluate MIC trends for clinical isolates of Staphylococcus aureus to vancomycin over a 5 year period (2002-06) in a hospital in Spain.

Methods: All clinical isolates of S. aureus (one per patient) from clinical samples of patients at Hospital Universitario de Getafe from January 2002 to December 2006 were used.

Enteral vancomycin controls methicillin-resistant Staphylococcus aureus endemicity in an intensive care burn unit: a 9-year prospective study.

Objective: The aim of this study was to assess the efficacy and safety of enteral vancomycin in controlling MRSA endemicity in an intensive care burn unit.

Summary Background Data: MRSA is a serious clinical and epidemiologic problem. It is not uncommon that the traditional maneuvers, detection and isolation of carriers, fail to control endemicity due to MRSA.

Survival benefit in critically ill burned patients receiving selective decontamination of the digestive tract: a randomized, placebo-controlled, double-blind trial.

Objective: To evaluate whether selective digestive decontamination (SDD) reduces mortality from any cause, and the incidence of pneumonia among patients with severe burns.

Summary Background Data: SDD is a prophylactic strategy to reduce infectious morbidity and mortality in critically ill patients. Two meta-analyses and a recent randomized controlled trial demonstrated a mortality reduction varying between 20% and 40%.

[Effect of selective digestive decontamination on the nosocomial infection and multiresistant microorganisms incidence in critically ill patients].

Background: Ventilator-associated pneumonia (VAP) is a common complication in mechanically ventilated patients. Other infections related to the use of invasive devices, such urinary tract infections (UTI) and central venous catheter-related bloodstream infections are found in patients admitted in intensive care units (ICU). Selective digestive decontamination (SDD) is a set of manoeuvres (hygiene, topic digestive antimicrobials and short course of systemic antibiotics) aimed at decreasing the incidence of nosocomial infections, mainly VAP, in ICU.